AB0385 RISK FACTORS AND CARDIOVASCULAR DISEASES AMONG PATIENTS WITH RHEUMATOID ARTHRITIS IN A TERTIARY GOVERNMENT HOSPITAL IN THE PHILIPPINES
Authors: M. A. Yano, E. Salido
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement<sub>.</sub><sup>[1]</sup> Comorbidities are highly prevalent in patients with RA, <sup>[2]</sup> in particular cardiovascular disease (CVD), which is responsible for over 50% of premature deaths among these patients.<sup>[3]</sup> It causes lower life expectancy in 3 to 10 years and higher mortality rate compared to the general population. <sup>[4]</sup> <h3>Objectives</h3> To describe cardiovascular (CV) diseases and their risk factors among patients with rheumatoid arthritis. <h3>Methods</h3> This is a review of the medical records of patients with rheumatoid arthritis, ambulatory and hospitalized, at the Philippine General Hospital from January 2019-December 2022. <h3>Results</h3> There were 123 patients included in the study, 95.1% were females with a mean age and disease duration of 51.31 and 9.78 years, respectively. Only a few (6.5%) were hospitalized. Disease activity was low in 41.5% and moderate in 35% based on disease activity score (DAS 28) and/or clinical disease activity index (CDAI) scores. Methotrexate (54%) was the most commonly used conventional synthetic disease modifying antirheumatic drug (csDMARD). The use of glucocorticoids was observed in 51.2% while no patients were on biologic (DMARD) at the time of data collection. There were 12 (9.7%) patients with CV diseases, namely myocardial infarction, heart failure, and stroke. There were 87 (70%) patients with at least one CV risk factor and 60 (48%) with multiple risk factors. The risk factors identified were: dyslipidemia (43.1%), hypertension (40.7%), elevated body mass index (35.7%), and diabetes mellitus, (15.4%). However, there were 18 (14.6%) patients without a lipid determination. Five hospitalized patients (4%) died, three from infectious causes, one from malignancy, and one from myocardial infarction. <h3>Conclusion</h3> The majority (70%) in our cohort had at least one CV risk factor and 10% had an identified CV disease. Dyslipidemia was the most common CV risk factor. The high proportion of patients with CV disease and risk factors highlights the need to add the screening and management of CV diseases as a priority among patients with rheumatoid arthritis. <h3>References</h3> [1]England BR, Thiele GM, Anderson DR, Mikuls TR. Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ. 2018 Apr 23;361:k1036. doi: 10.1136/bmj.k1036. PMID: 29685876; PMCID: PMC6889899. [2]Dougados M, Soubrier M, Antunez A, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis 2014; 73:62–8. [3]Symmons DPM, Gabriel SE. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol 2011; 7:399–408 [4]Myasoedova E, Davis JM, Crowson CS, Gabriel SE. Epidemiology of rheumatoid arthritis: rheumatoid arthritis and mortality. Curr Rheumatol Rep. 2010;12(5):379–85. https://doi.org/10.1007/s11926-010-0117-y. <h3>Acknowledgements</h3> I have no acknowledgments to declare. <h3>Disclosure of Interests</h3> None Declared.